Prevalence of depression in patients affected by subclinical hypothyroidism – Source: Panminerva Medicine, Dec 2010

[Note: Subclinical hypothyroidism is a low-thyroid condition in which free thyroxine (T4) is normal and thyroid stimulating hormone (TSH) is between 5 and 25 mU/L. Though many doctors assume it doesn’t really have symptoms, others contend it does, and this study appears to indicate it is associated with depressive symptoms in the majority of cases, which generally are not eliminated by the thyroid hormone drug levothyroxine alone.]

Aim: The aim of this study was to:

• Estimate the prevalence of depressive symptoms in patients affected by subclinical hypothyroidism by means of Hamilton Rating Scale for Depression (HAM-D) and Montgomery-Asberg Depression Rating Scale (MADRS);

• To assess which depressive symptoms are prevalent in our population, with references to the factorialization of HAM-D by Cleary and Guy (1977);

• To verify whether levothyroxine replacement therapy alone can induce total remission of depressive symptoms. [Levothyroxine is a thyroid hormone used to treat hypothyroidism and goiter (enlarged thyroid gland).


The study enrolled 63 patients affected by subclinical hypothyroidism undergoing follow-up at the endocrinology service of San Paolo Hospital in Milan.

All patients underwent an evaluation by means of HAM-D and MADRS scales and serum TSH, free T4, free T3, TPO-Ab and Tg-Ab levels were measured.


We estimated a prevalence of depressive symptoms in our population of 63.5%.

Concerning the qualitative assessment of psychiatric disturbances in the population we considered, our results showed that the most frequent symptoms were part of four factors, according to the Cleary and Guy factorialization of HAM-D: these factors are representative of:

• Anxiety and somatisation (factor I),

• Cognitive impairment disturbances (factor III),

• Psychomotor retardation (factor V),

• And sleep disorders (factor VI).

Levothyroxine replacement therapy alone wasn’t effective in inducing total remission of depressive symptoms.

Conclusion: This study suggests the importance of a psychiatric evaluation in patients affected by subclinical hypothyroidism.

Source: Panminerva Medicine, Dec 2010;52(4):277-82. PMID: 21183887 by Demartini B, Masu A, Scarone S, Pontiroli AE, Gambini O. Department of Psychiatry, San Paolo Hospital, University of Milan, Milan, Italy. [Email:]

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